The Nexus of Gender, Age and Ability

Moreover, our “obstinately persisting misunderstanding” of autism originates largely from clinical and epidemiological studies with children [13]. When the term “Autism” is used it most often conjures a mental image of a male aged 4/5 years with the most extreme/ debilitating presentation encompassing limited verbal ability, selfdirected social isolation, and engagement in repetitive structured activity. Indeed, Klin indicates that “Autism” has also been known as autistic disorder, childhood autism, infantile autism, and early infantile autism, which demonstrate the inherent bias toward the earlier years of life [14].

Historically, it has been during childhood that autism is often first noticed, and much is written about children with autism; but autism is first and foremost a disorder of development: the clinical picture can evolve (dramatically) over time, with symptoms changing, emerging, and/or disappearing [15]. Autism is, therefore, lifelong but relatively little is known about autism in adulthood, which has only recently come into focus [16].

Furthermore, the common understanding of autism considers the most severe forms of impairment (i.e., the so-called ‘low-functioning’ individuals); however, the DSM-V derived spectrum of autism necessarily means that a myriad of presentations will arise, and the classification also accounts for the degree of severity: ranging from those experiencing the most severe presentation to those whom are able to lead independent and fulfilling lives [17].

Indeed, the focus on the less severe end of the spectrum, wherein individuals are often referred to as having so-called “high-functioning autism” (hereafter HFA), has often been overlooked. The very nature of this terminology, however, can be considered misleading, as qualitative parameters such as “low” and “high” may infer an inaccurate perception of an individual’s strengths and talents, or challenges and difficulties in the context of that person’s life.